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Topic Contents

Problems After Delivery of Your Baby

Topic Overview

During the days and weeks after the delivery of your baby (postpartum period), you can expect that your body will change as it returns to its nonpregnant condition. The postpartum period lasts for 3 months after delivery. As with pregnancy changes, postpartum changes are different for every woman. For example, if you had heartburn while you were pregnant, it may go away after delivery. But other symptoms, such as hemorrhoids, could continue to cause problems after your baby is born.

Many minor postpartum problems can be managed at home. For example, home treatment measures are usually all that is needed to relieve mild discomfort from hemorrhoids or constipation. If you develop a problem and your doctor has given you specific instructions to follow, be sure to follow those instructions.

Most women need some time after delivery to return to their normal activities. It is important to focus on your healing and taking care of your baby for the first 6 weeks. Start other activities slowly as you feel stronger. Your doctor will tell you when you can have sex again, but for most women, 6 to 8 weeks after delivery is the average time. If you had any problems during your pregnancy or during labor or delivery, your doctor may give you more specific instructions about activities.

If you're not sure if a fever is high, moderate, or mild, think about these issues:

With a high fever:

You feel very hot.

It is likely one of the highest fevers you've ever had. High fevers are not that common, especially in adults.

With a moderate fever:

You feel warm or hot.

You know you have a fever.

With a mild fever:

You may feel a little warm.

You think you might have a fever, but you're not sure.

Temperature varies a little depending on how you measure it. For adults and children age 12 and older, these are the ranges for high, moderate, and mild, according to how you took the temperature.

Oral (by mouth) temperature

High:104°F (40°C) and higher

Moderate:100.4°F (38°C) to103.9°F (39.9°C)

Mild:100.3°F (37.9°C) and lower

A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature.

Ear or rectal temperature

High:105°F (40.6°C) and higher

Moderate:101.4°F (38.6°C) to104.9°F (40.5°C)

Mild:101.3°F (38.5°C) and lower

Armpit (axillary) temperature

High: 103°F (39.5°C) and higher

Moderate:99.4°F (37.4°C) to102.9°F (39.4°C)

Mild: 99.3°F (37.3°C) and lower

Blood in the stool can come from anywhere in the digestive tract, such as the stomach or intestines. Depending on where the blood is coming from and how fast it is moving, it may be bright red, reddish brown, or black like tar.

A little bit of bright red blood on the stool or on the toilet paper is often caused by mild irritation of the rectum. For example, this can happen if you have to strain hard to pass a stool or if you have a hemorrhoid.

Certain medicines and foods can affect the color of stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food coloring can turn the stool black.

If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

Symptoms of a vaginal infection may include:

Vaginal itching.

Vaginal discharge that is not normal for you.

Red, irritated skin in the vaginal area.

Pain when you urinate.

Pain or bleeding when you have sex.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

Passing out (losing consciousness).

Feeling very dizzy or lightheaded, like you may pass out.

Feeling very weak or having trouble standing.

Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Pain in adults and older children

Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.

Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Symptoms of difficulty breathing can range from mild to severe. For example:

You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).

It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

You cannot talk at all.

You have to work very hard to breathe.

You feel like you can't get enough air.

You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

It's hard to talk in full sentences.

It's hard to breathe with activity.

Mild trouble breathing means:

You feel a little out of breath but can still talk.

It's becoming hard to breathe with activity.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.

Long-term alcohol and drug problems.

Steroid medicines, which may be used to treat a variety of conditions.

Chemotherapy and radiation therapy for cancer.

Other medicines used to treat autoimmune disease.

Medicines taken after organ transplant.

Not having a spleen.

Symptoms of a bladder infection may include:

Pain or burning when you urinate.

A frequent urge to urinate without being able to pass much urine.

Blood in the urine.

Symptoms of a kidney infection may include:

Pain in the flank, which is felt just below the rib cage and above the waist on one or both sides of the back.

Fever or chills.

Pain or burning when you urinate.

A frequent urge to urinate without being able to pass much urine.

Belly pain.

Symptoms of a pulmonary embolism may include:

Sudden shortness of breath.

Sudden, sharp chest pain that may get worse when you breathe deeply or cough.

Coughing up blood or pink, foamy mucus.

Fast heart rate.

Severe anxiety.

Fainting.

Severe vaginal bleeding means that you are soaking 1 or 2 pads or tampons in 1 or 2 hours, unless that is normal for you. For most women, passing clots of blood from the vagina and soaking through their usual pads or tampons every hour for 2 or more hours is not normal and is considered severe. If you are pregnant: You may have a gush of blood or pass a clot, but if the bleeding stops, it is not considered severe.

Moderate bleeding means that you are soaking more than 1 pad or tampon in 3 hours.

Mild bleeding means that you are soaking less than 1 pad or tampon in more than 3 hours.

Minimal vaginal bleeding means "spotting" or a few drops of blood.

Some of the problems with breastfeeding that you might have include:

Sore, red nipples.

Stabbing or burning breast pain.

A hard lump in your breast.

Your baby having trouble latching onto your breast.

If you have pain when you are breathing, you may be at immediate risk for a pulmonary embolism if you also have:

Pain deep in one leg for no clear reason. This can be a sign of a blood clot in the leg (deep vein thrombosis) that could travel to the lungs.

A history of problems with blood clots, such as deep vein thrombosis or a previous pulmonary embolism.

Symptoms of postpartum depression may include:

Trouble sleeping.

Feeling sad or hopeless.

Crying often, or feeling like you are going to cry.

Feeling anxious or edgy.

Not being able to concentrate.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms and arrange for care.

If you cannot reach your doctor or you don't have one, seek care today.

Call 911 Now

Home Treatment

If you develop problems and your doctor has given you specific instructions to follow, be sure to follow those instructions.

Feeling tired (fatigue)

Most women feel tired after labor and delivery. Caring for a new baby, loss of sleep, and the normal physical changes you experience as your body returns to its nonpregnant condition can add to your fatigue. It is important to focus on your healing and taking care of your baby for the first 6 weeks. Start other activities slowly as you feel stronger.

To help with fatigue in the first few weeks and months after delivery:

Eat regularly. Do not skip meals or go for long periods without eating. Choose healthy foods.

Exercise regularly. Get outside, take walks, or keep your blood moving with your favorite workout. If you do not have your usual energy, do not overdo it. If you had any problems during your pregnancy or during labor or delivery, your doctor may give you more specific instructions about activities.

Try to take rest breaks often during the day.

Do only as much as you need to, and do not take on extra activities or responsibilities.

Spend time with family and friends and let them help you care for your baby.

Sleep problems

Sleep problems are common when you are caring for a new baby. These tips may help you get a good night's sleep.

Sleep when your baby is sleeping or napping.

Keep your naps as short as possible.

Use your bed only for sleep.

Try to have a regular feeding pattern if you are breastfeeding. If you are bottle-feeding, have others feed the baby sometimes so you can rest.

Nonprescription medicine to help relieve discomfort

Most women have some mild discomfort after delivery. You may have some cramping as your uterus returns to its nonpregnant size. If you had an episiotomy, you may have pain in your genital area. Women who have had a cesarean section (C-section) will have some pain at the incision site.

Most women can take acetaminophen (such as Tylenol) and ibuprofen (such as Advil) while breastfeeding to help relieve discomfort from some of these problems. But talk to your doctor before taking any medicine (prescription or nonprescription).

Acetaminophen dosage: The usual dose is 650 mg; recommended doses may range from 500 mg to 1,000 mg. You can take 650 mg every 4 hours or 1,000 mg every 6 hours in a 24-hour period. Do not take more than the maximum adult dose of 4,000 mg in a 24-hour period.

Be sure to follow these nonprescription medicine precautions.

Use, but do not take more than the maximum recommended doses.

Carefully read and follow all labels on the medicine bottle and box.

Breast engorgement or mastitis

If you are breastfeeding, your breasts may be sore as they fill with milk. Place ice packs on your breasts for the pain and swelling. Be sure to put a cloth between your skin and the ice pack. Some women find a hot shower or warm towels on the breasts help the pain. You can also use acetaminophen, such as Tylenol.

Mastitis is an inflammation of the breast that is most commonly related to breastfeeding. This inflammation can be related to tissue injury, infection, or both. Mastitis while breastfeeding usually affects only one breast and starts as a painful area that is red or warm. Fever, chills, and flu-like symptoms or body aches can also develop. You can develop mastitis at any time while breastfeeding, but it most commonly occurs during the first 2 months after delivery, before your baby's feeding patterns become regular.

If you are not breastfeeding, do not stimulate your nipples or warm your breasts. Instead, apply cold packs, use medicine for pain and inflammation, and wear a supportive bra that fits well.

Postpartum depression

Many new mothers may feel "blue" after the birth of their baby. This may be caused by a change in hormones, not getting enough sleep, feeling too busy, or just worried about taking care of the baby.

Postpartum depression is a medical condition, not a sign of weakness. Be honest with yourself and those who care about you. Tell them about your struggle. You, your doctor, and your friends and family can team up to treat your symptoms.

Plan activities and visit with friends and family, and ask them to call you regularly.

Eat a nutritious diet. Eat small snacks throughout the day to keep up your energy.

Constipation and hemorrhoids

Constipation and hemorrhoids may bother you after delivery. To prevent or ease these symptoms:

Eat a high-fiber diet with lots of fruits, vegetables, and whole grains.

Drink plenty of fluids, especially water.

Try a stool softener, such as Colace.

Do not strain (push hard) during a bowel movement.

Get more exercise every day.

If you had a tear in your genital area during delivery (episiotomy), talk to your doctor before using any nonprescription suppositories for constipation.

To treat the itching or pain of hemorrhoids:

Keep the anus clean by wiping carefully after each bowel movement. Gently wipe from the front to the back. Baby wipes or hemorrhoid pads are usually more gentle than toilet paper. If you use toilet paper, use only soft, undyed, unscented toilet paper.

Take warm soaks in a tub or a sitz bath. Warm water can help soothe hemorrhoids. Add baking soda to the water to relieve itching.

Use cold packs.

Do not sit for long periods, especially on hard chairs.

Let your doctor know if you are having problems with constipation or hemorrhoids. He or she may recommend a nonprescription or prescription medicine to treat your hemorrhoids.

Swelling

If you had mild swelling from normal fluid buildup when you were pregnant, it may last for days or weeks after you deliver. You are most likely to notice this swelling in your face, hands, or feet. As your body changes back to how it was before you were pregnant, the swelling will go away.

To help with swelling in your lower legs:

Whenever you are resting, raise your legs up. Try to keep the swollen area higher than the level of your heart.

Take breaks from standing or sitting in one position.

Walk around to increase the blood flow in your lower legs.

Move your feet and ankles often while you stand, or tighten and relax your leg muscles.

Problems with the veins in the legs (varicose veins) and changes in hormones can also cause swelling. If the swelling in your ankles and feet does not go away or gets worse after trying home treatment, talk to your doctor about your symptoms.

Weight loss

Just as you slowly gained weight during your pregnancy, it may take some time to lose weight after your baby is born. Eat a nutritious diet and try to exercise daily. It may take 6 to 8 weeks for you to get back to your normal activities. As the body returns to its nonpregnant condition, many women feel they can manage their weight with healthy eating and exercise. If it is hard for you to lose weight from your pregnancy, talk to your doctor about your goals. If you are breastfeeding, it is important to get the right amount of calories and nutrients for your baby.

Prevention

It is important to make healthy lifestyle choices to lower your chance for problems after your delivery.

Get plenty of rest.

Limit your use of caffeine if you are breastfeeding.

Eat a nutritious diet. Healthy eating will help you get the right balance of vitamins, minerals, and other nutrients. It will help you feel your best and have plenty of energy. If you are breastfeeding, it is important to get good nutrition for you and your baby.

Try to get 30 minutes of exercise on most, if not all, days of the week.

Do pelvic floor (Kegel) exercises to prevent urine control problems (incontinence) after childbirth.

Things to avoid if you are breastfeeding

Alcohol

Illegal drugs

Misusing medicines

Fish that contain high levels of mercury. This includes shark, swordfish, king mackerel, marlin, orange roughy, bigeye tuna, or tilefish from the Gulf of Mexico. Avoid eating more than 4 oz (113 g) a week of white albacore tuna. Canned light tuna is low in mercury and a better option. And avoid eating more than 4 oz (113 g) a week of fish caught in local waters that have not tested as safe.

Hazardous chemicals, certain cosmetic products, or radiation

Call your doctor if you have any questions about breastfeeding. This may help prevent any problems.

Preparing For Your Appointment

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

What are your main symptoms?

How long have you had your symptoms?

Have you had this problem before? If so, do you know what caused the problem at that time? How was it treated?

What activities make your symptoms better or worse?

Do you think that activities related to your job or hobbies caused your symptoms?

Do you think that exercise or sports activities have caused your symptoms?

What home treatment measures have you tried? Did they help?

What prescription or nonprescription medicines have you taken or used? Did they help?

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